TY - JOUR T1 -脑脓肿并发癫痫的危险因素和预后:一项全国性人群队列研究JF - Neurology JO - Neurology DO - 10.1212/WNL.0000000000206866首页Sp - 10.1212/ wnl.0000000000206866AU -雅各布Bodilsen盟Læ驾驶台Storgaard Duerlund盟基督教托马斯·布兰德-泰斯Mariager盟盟-洛萨非盟威斯皮尔特里尔彼得森AU -吕克拉森盟Birgitte Rø濒死经历汉森AU - Lars Haukali Omland AU -马尔特•摩斯Tetens AU -拉姆Langelund Jørgensen盟Steffen赖斯称非盟-亨利克·尼尔森Y1 2023/02/21 UR - //www.ez-admanager.com/content/early/2023/02/21/WNL.0000000000206866.abstract N2 -背景和目标:首页癫痫在脑脓肿患者中很常见，但危险因素和预后尚不明确。这项研究调查了脑脓肿幸存者癫痫的危险因素和相关预后。方法:在全国范围内，使用基于人群的医疗保健登记，计算1982年至2016年30天脑脓肿幸存者中癫痫的累积发病率和原因特异性调整危险率比(adj. HRRs)， 95%置信区间(ci)。通过回顾2007年至2016年住院患者的病历，丰富了数据中的临床细节。将癫痫作为时间依赖变量，对调整后的死亡率比率(MRRs)进行检查。结果:该研究包括1179名30天脑脓肿幸存者，其中323人(27%)在中位数为0.76年后发生新发癫痫(四分位数范围[IQR] 0.24-2.41)。因脑脓肿入院时，癫痫患者的中位年龄为46岁(IQR 32-59岁)，而无癫痫患者的中位年龄为52岁(IQR 33-64岁)。 The proportion of females was similar in patients with and without epilepsy (37%). Adj. HRRs for epilepsy were 2.44 (95% CI 1.89-3.15) for aspiration or excision of brain abscess, 2.37 (1.56-3.60) for alcohol abuse, 1.75 (1.27-2.40) for previous neurosurgery or head trauma, 1.62 (1.17-2.25) for stroke, and 1.55 (1.04-2.32) for age group 20-39 years. Cumulative incidences were increased in patients with alcohol abuse (52% vs 31%), aspiration or excision of brain abscess (41% vs. 20%), previous neurosurgery or head trauma (41% vs. 31%), and stroke (46% vs. 31%). Analysis using clinical details from medical record review of patients from 2007 through 2016 demonstrated adj. HRRs of 3.70 (2.24-6.13) for seizures at admission for brain abscess and 1.80 (1.04-3.11) for frontal lobe abscess. In contrast, adj. HRR was 0.42 (0.21-0.86) for occipital lobe abscess.Using the entire registry-based cohort, patients with epilepsy had an adj. MRR of 1.26 (1.01-1.57).Discussion: Important risk factors for epilepsy were seizures during admission for brain abscess, neurosurgery, alcoholism, frontal lobe abscess, and stroke. Epilepsy was associated with increased mortality. Anti-epileptic treatment may be guided by individual risk profiles and specialized follow-up is highlighted by increased mortality in survivors with epilepsy. ER -